Doctors Lounge - Urology Answers
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Forum Name: Urology Topics
Question: chronic left flank pain
|Beth Norr - Tue Feb 20, 2007 5:41 am|
I have been having chronic left flank pain now for months. I am a 47 year old female. I have had a hysterectomy and my right ureter reimplanted due to complications from removing my righ ovary 6 years ago.
Over the past months my left flank has been swelling. You can see it with the naked eye. It is getting worse. I feel pressure as well as pain. It came on suddenly and has never left. Ultrasound and CT scan are negative except for a little abnormality of left kidney. They said not vary impressive. Interestingly enough, they put me on steroids for inflammation and on the third day you could see a huge difference in the swelling and the pressure is not as bad. My urine output has also increased since the steroid therapy. Although urine is clear with trace blood.
The pain and intense pressure is to the point that it is getting much worse. Steroids do help some.
History....mva 2 years ago...C7 sublexation. Also, I am now having severe left sided hip pain.
|Dr. Chan Lowe - Tue Feb 20, 2007 2:49 pm|
Your symptoms are quite interesting. When you say that your urine output has increased, did you notice that you had difficulty urinating before the steroids-as if something was obstructing the urine flow?
Also, could you see the swelling at the time the ultrasound and CT scan were done? If so, did they comment that the soft tissues appeared edematous?
I can think of several causes of abdominal/pelvic swelling but they should be seen on a CT scan.
I would recommend that you continue to follow up with your doctor. An MRI may give better evaluation of the soft tissues to look for swelling or other anomalies.
Sorry I can't be of much more help at this point. Direct physical examination is important and I encourage you to keep working with your doctor until a cause is found.
Keep us updated.
|Beth Norr - Tue Feb 20, 2007 6:32 pm|
Thank you for your response. In answer to your questions, yes, before steroids urine flow seemed sluggish. Not so much now. Relief would be the word....As for the scans., the CT didn't show much of anything so they said but the ultrasound showed some edema with soft tissue and the left kidney a bit different but nothing major. The pain still continues. One note that I didn't mention before....the pain is from the upper left abdominal quadrant and wraps around the left side to the middle of my back. The point of the most intense pain moves around from time to time. Also, when I am most swollen, I feel a frequent flutter just below my sternum. It drives me nuts because it won't stop. And...I can't lay down on my right side as too much intense pressure is on my left and I can't stand it.
I plan to keep trying to get to the bottom of this because I have to resolve it. It is getting worse.
|Dr. Chan Lowe - Tue Feb 20, 2007 9:35 pm|
Do you know if the CT scan that was performed was done with contrast or without. To most effectively pick up kidney stones, contrast is the best. A non-contrast CT, or a CT that had too thick of cuts may miss the stone.
Your pain symptoms are quite suspicious for a kidney stone. In addition, steroids would help decrease inflammation and possibly alleviate an obstruction due to swelling around a stone or other blockage. The blood in the urine fits this diagnosis as well.
Ultrasounds will show stones if they happen to be in the kidney. If the stone has moved into the ureter and ultrasound is less effective at seeing them. CT scan with contrast is the best way to find them.
I encourage you to continue to follow up with your doctor, and possibly see a urologist for further diagnostic testing.
Keep us updated.
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